†Schneider M. Autopsies: A third of Pulse nightclub victims shot in head.

Associated Press. August 9, 2016. Available at: media.abcnews.com/m/
story?id=41243474&sid=81. Accessed September 7, 2016.
sustained no intracranial injuries. Triage, evaluation,
and resuscitation of the second wave of patients began.

Police officers warned that numerous victims werestill in the nightclub and that we should expect a thirdwave of victims. These remaining 40 victims, one-thirdwith gunshot wounds to the head and some with upto 10 injuries, were subsequently found to have suc-cumbed to their injuries, and the “third wave” nevermaterialized.†At 7: 30 am the trauma surgeons who were notstill operating met with the general surgery resi-dents in the ED. Using a master list of victims thatDr. Smith had maintained throughout the morning,each patient’s injuries, laboratory data, and radiologicstudies were carefully reviewed and a tertiary surveyperformed to ensure that all injuries had been notedand addressed.

The large number of victims brought to area
hospitals and the number of deceased victims still
within the club resulted in an unprecedented influx
of concerned families. A family assistance area was
established and staffed by hospital personnel. Regular
updates were provided to families whenever possible.

Families were provided with an e-mail address to sendphotographs and other details to assist in the identifica-tion of the victims. More than 300 e-mails were receivedfrom family and friends attempting to locate their lovedones. All but one of the victims who received care atORMC was identified by that afternoon.

Evaluating the response

Of the 107 victims of this mass shooting, 49 were killed
and 58 were wounded. ORMC received 49 victims plus
the SWAT team member; nine succumbed to their injuries soon after arrival. Another 17 victims, some of
whom initially fled the scene of the attack, presented
to other local hospitals by EMS or private vehicle. A
total of 40 victims died in the club.

The proximity of the nightclub to ORMC was certainly of benefit to the victims. While the first law
enforcement officers on the scene were engaging the
shooter, others extricated victims from the club to a
casualty collection point across the street. Law enforcement vehicles and the initially responding ambulances
began immediately transporting victims the short distance to ORMC, frequently carrying more than one
patient per trip, and immediately returning to the scene
after offloading. One-third of the victims were quickly
transported to the trauma center by law enforcement
using pickup trucks and patrol cars. This rapid transfer